| Overview : Despite the global decline in new HIV infections, the Arab region currently has one of the fastest growing epidemics. According to UNAIDS 2013 Regional Report for the Middle East and North Africa (MENA), by 2012, 270,000 people were living with HIV, that is 134% increase since in 2001. With a few exceptions (Djibouti and Somalia), the majority of the HIV epidemic in this region is concentrated among key population at higher risk (people who inject drugs, men who have sex with men and sex workers).
Jordan is a Middle Eastern, upper middle income country with a Gross National Income (GNI per capita) of USD 4, 340 (World Bank, 2011). Jordan’s 2010 statistics indicate that the population is about 6.1 million (51.5% males and 48.5% females). Despite Jordan experiencing an epidemiological transition in the pattern of disease, best characterized by a shift from communicable to chronic non communicable diseases (cardiovascular diseases, cancer, diabetes and chronic respiratory infections), the emergence of new communicable diseases like HIV, Hepatitis C and E constitutes a burden on the health system in Jordan (MoH/CCD, 2010). Jordan is still characterised by a relatively low prevalence of HIV, but a silent increase has been seen in recent years, especially outspoken among mmost at risk population groups, including Men who have sex with men (MSM), Female Sex Workers (FSWs) and Injecting Drug Users (IDUs).
Despite low prevalence, a number of socioeconomic and political factors also fuel the silent spread of the epidemic, among others, poverty, unemployment, sexual and gender-based violence, regional conflict and large population movements.
One major challenge in rolling out broad HIV/AIDS prevention initiatives remains to be Jordan’s cultural sensitivities, currently posing the greatest threat to the country’s low prevalence. Because of difficulties in discussing sexual matters, many Jordanians still harbor misconceptions about HIV/AIDS. According to the latest report on HIV in Jordan (UNAIDS 2011) the proportion of interviewees who knew that condom use can protect from HIV transmission was only half of the respondents; 42% did not know this piece of information. Some misconceptions on HIV modes of transmission were also evident; only 44% of the respondents knew that a person cannot get HIV by sharing a meal with an HIV positive person and almost a third of them were not aware that a healthy looking person can be living with HIV and that a mother can transmit HIV to her unborn child.
Furthermore, the significant bulk of youth in Jordan (approx. 70% under 30 years of age), constitutes a major opportunity to limit the spread of HIV, and on the other hand, if not prevented adequately, a significant threat for further spread.
An equally serious worry is the living conditions and human rights of already affected individuals and their families. The level of poverty experienced by people living with HIV remain a concern affecting their ability to access or maintain their access to health and social services and exacerbating the impact of the epidemic. While better-off families can offset their losses in income resulting from AIDS with other assets, poor people are more likely to resort to adverse coping strategies (reducing education, food and health expenditures or sending their children to work) that can result in significant loss of human capital.
At the national level, Jordan’s response to HIV has been characterized by relatively strong political commitment. The Ministry of Health established the National AIDS programme at the time the first HIV case was discovered in 1986. Jordan launched the National HIV/AIDS Strategy (2005–2009) and the new National Strategic Plan on HIV and AIDS (2012-2016) . The five strategic areas of intervention is currently 1. Surveillance, Research, M&E 2. Quality, comprehensiveness & coverage of MARPs programme 3. Focus on most vulnerable groups among general population (incl. VCT) 4. Treatment & Care for PLHIV 4. Supportive legal, policy and social environments 5. Strengthen institutional and technical capacity.
Despite of a relatively well envisioned national strategy, the necessary priority given of HIV/AIDS is still vague, and institutional and organizational capacity and coordination remains deficient.
UNDP supports countries to integrate attention to HIV in national planning, among others through the promotion of enabling human rights and legislative environments to reduce vulnerability to HIV and strengthen governance and coordination of national responses.
The 2013-2017 United Nations Development Assistance Framework (UNDAF) focuses on health and HIV/AIDS under Priority 2 “Ensuring Social Equity” (output 3.4 ) and devotes special attention to youth and HIV/AIDS under Priority 3, “Investing in Young People”, output 4.4
In this context, the present consultancy will focus on how the to accelerate and scale up the Jordanian effort in preventing HIV, and ensuring respect for human rights of already affected population, with special attention to youth. |
